122 articles - From Friday Jul 19 2024 to Friday Jul 26 2024
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gastroenterology |
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AGA Clinical Practice Update on Diagnosis and Management of Cyclic Vomiting Syndrome: Commentary. Methods This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This expert commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors who are experts in treating patients with cyclic vomiting syndrome. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
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Meta-analysis: High pooled positive predictive value of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition no-biopsy approach for coeliac disease testing in children. Both no-biopsy criteria exhibit high PPV when compared to the reference standard. These results provide a consistent message of accuracy and feasibility to inform change and improve outcomes. |
| Am J Gastroenterol |
Using Diet to Treat Inflammatory Bowel Disease: A Systematic Review. Currently, there is limited evidence to support the use of specific diets to treat adult patients with mildly to moderately active IBD. Larger, randomized studies with standardized methodologies and outcome measures, rigorous adherence assessment, and an emphasis on endoscopic assessment outcome measures are required to validate most diets that have been studied for IBD. The included sample diet plans and dietary recommendations may prove helpful in the interim as part of a holistic strategy to manage patients with IBD. |
| Clin Gastroenterol Hepatol |
Disparities for Hispanic Adults with metabolic dysfunction-associated steatotic liver disease in the US: A Systematic Review and Meta-analysis. Health disparities for US Hispanic adults continue to worsen with significantly higher relative risk of MASLD and MASH compared to non-Hispanic adults. Public health efforts to optimize screening and care delivery for adult Hispanic population are urgently needed. |
| Gastrointest Endosc |
Risk and Pathological Factors of Recurrence after Endoscopic Resection for Superficial Esophageal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis. The recurrence rate of superficial ESCC after ER is acceptable. Patients with positive margins, LVI, LI and SM1 need to pay significant attention to the risk of recurrence. LI and VI should be evaluate separately. (PROSPERO CRD42023406309). |
| Hepatology |
Comparative efficacy of pharmacologic therapies for MASH in reducing liver fat content: Systematic review and network meta-analysis. This study provides an updated, relative rank-order efficacy of therapies for MASH in reducing hepatic fat. These data may help inform the design and sample size calculation of future clinical trials and assist selection of combination therapy. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
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Efficacy and safety of risankizumab by baseline corticosteroid use and achievement of corticosteroid-free clinical and endoscopic outcomes in patients with moderately to severely active Crohn's disease. Efficacy of risankizumab 600 mg induction therapy was independent of concomitant corticosteroid use. Risankizumab 180 and 360 mg maintenance therapy yielded high rates of corticosteroid-free clinical and endoscopic outcomes at week 52. |
Prevalence and prognosis of patients with MASLD-related cirrhosis after an ICU hospitalization in France: A single-centre prospective study. MASLD or MetALD was responsible for ⅓ of the causes of cirrhosis in the ICU. MASLD-related cirrhosis is as severe as ALD-related cirrhosis. Liver transplantation should be rapidly discussed. |
| Am J Gastroenterol |
Antigliadin antibodies and the brain in people without celiac disease: a case-control study. Our analysis is the most comprehensive to date and utilises a number of outcome measures known to be sensitive to subtle shifts in neurophysiology and cognition. Incidental AGA does not appear to be associated with any indications of neuropsychological deficit. |
Deep learning model using stool pictures for predicting endoscopic mucosal inflammation in patients with ulcerative colitis. DLSUC demonstrated a good discriminating power similar to that of Fcal in predicting endoscopic activity with improved accuracy in patients without rectal sparing. This study implies that stool photos are a useful monitoring tool for typical UC. |
Delivery of Outpatient Cirrhosis Care Via Tele-visit is Not Associated with Increased Mortality as Compared to Traditional In-Person Visits. Our findings suggest that outpatient cirrhosis care by tele-visit is associated with outcomes no worse than traditional in-person visits. This should reassure providers who hesitate to provide virtual care to patients with cirrhosis due to concerns for poorer outcomes. |
Inpatient Gastroenterology Consults Have Little Utility Prior to Transesophageal Echocardiograms in a Prospective Cohort Study. Inpatient GI team workups to clear patients for a TEE found no contraindications to TEEs, did not change patient care plans, and led to increased hospital costs and lengths of stay. |
Linear-array Endoscopic Ultrasound and Narrow-Banding Imaging Measure the Invasion Depth of Nonpedunculated Rectal Lesions with Comparable Accuracy based on a Randomized Controlled Trial. Linear EUS and NBI measure the invasion depth of NPRLs with comparable accuracy. The combination of the two methods does not improve the diagnostic accuracy. Single NBI should be preferred, considering its simplicity and convenience in clinical practice. |
The Association Between Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Exposure and Key Cirrhosis-Related Outcomes. ACE-I/ARB exposure was associated with reduced mortality, potentially through CV and other (renal, malignancy-related) mechanisms. In patients with compensated disease, ACE-I/ARB was not associated with hepatic decompensation or HCC. Future research should identify subsets of patients who benefit from ACE-I/ARB exposure. |
| Clin Gastroenterol Hepatol |
Dynamics of liver stiffness measurement and clinical course of primary biliary cholangitis. Tracking longitudinal changes in LSM using VCTE provides valuable insights into PBC prognosis, offering a robust predictive measure for the risk of SCE. LSM could be used as a clinically relevant surrogate endpoint in PBC clinical trials. |
Mucosal Healing With Vedolizumab in Patients with Chronic Pouchitis: EARNEST, a Randomized, Double-Blind, Placebo-Controlled Trial. Vedolizumab induced endoscopic improvements in patients with chronic pouchitis, which was associated with improved outcomes at W34, particularly in patients achieving MH at W14. number, NCT02790138. |
| Endosc Int Open |
Learning curve for endoscopic submucosal dissection (ESD) in the United States: Large, untutored, single-operator experience. Following ex-vivo training in an animal model, an untutored expert operator achieved competency in ESD between 250 and 350 procedures. Our data can inform development of future training programs in the West. |
Value of green sign and chicken skin aspects for detecting malignancy of colorectal neoplasia in a prospective characterization study. The green sign may be associated with malignant colorectal neoplasia. Targeting these areas before precise analysis of the lesion could be a way of improving detection of focal malignancies and prediction of the most severe histology. |
| Endoscopy |
A Sub-epithelial Lesion Algorithm For Endoscopic (SAFE) Resection In The Upper Gastrointestinal Tract. U-SELs may be effectively and safely treated by endoscopic resection. The SAFE approach provides a framework that facilitates structured decision-making. Oesophageal U-SELs suspected to involve the MP should undergo STER. Gastric SELs can be best managed by ESD with a view to proceed to exposing-EFTR. A laparoscopic UGI surgeon should be available in case surgical retrieval of the specimen or laparoscopic completion is required. |
Comparative Outcomes of Endoscopic Mucosal Resection for Laterally Spreading Lesions in Inflammatory Bowel Disease. Recurrence of LSLs after EMR appears more frequent in patients with IBD. Given the added complexity, EMR in patients with IBD should be performed in expert centers with close endoscopic surveillance. |
Correlation of EUS-guided portal pressure gradient measurements with hepatic venous pressure gradient: a prospective study. The correlation between EUS-PPG and HVPG was almost perfect. EUS-PPG could be a safe and reliable method for direct PPG measurement in cirrhotic patients and a valid alternative to HVPG. NCT05689268. |
Effect of Transcutaneous Electrical Nerve Stimulation Based on Wrist-Ankle Acupuncture Theory for Pain Relief during Non-Anesthetic Colonoscopy: A Randomized Controlled Trial. TENS-WAA effectively reduces pain during non-anesthetized colonoscopy, especially in male participants, providing a promising non-invasive analgesic method. |
Polyp size measurement during colonoscopy using a virtual scale: variability and systematic differences. We evaluated the method-specific variance (as measure of variability) in polyp size measurements and systematic differences between these methods. Results Variance in polyp size measurements was significantly lower for VS measurements compared to visual and snare measurements for both experts (0.52 vs 1.59 and 1.96, p Use of the VS leads to lower polyp size measurement variability and more uniform polyp sizing by individual endoscopists compared to visual and snare measurements. |
| Gastroenterology |
Cancer-associated endocrine cells participate in pancreatic carcinogenesis. Our study systematically maps the alteration of pancreatic endocrine cells in PDAC and elucidates the potential endocrine-exocrine interaction mechanisms during PDAC carcinogenesis. Meanwhile, we first time define and characterize cancer-associated endocrine cells (CAEs), thereby further broadening the composition of PDAC microenvironment. |
The global incident gastrointestinal cancers attributable to suboptimal diets from 1990 to 2018. Although the proportional attributable GI incidence remains relatively stable, the doubling of absolute cases from 1990 to 2018, along with the discrepancies among urbanicity and countries/regions, informs dietary priorities and more targeted preventive measures. |
| Gastrointest Endosc |
A prospective randomized controlled trial of water exchange plus cap versus water exchange colonoscopy in unsedated Veterans. Unsedated colonoscopy was appropriate for unescorted Veterans. WE alone was sufficient. Adding a cap did not reduce RTMIP. Patient specific factors and application of WE with insertion suction of infused water contributed to high and low RTMIP, respectively. For unesorted patients, selecting those with low anxiety, avoiding low body mass index, history of depression or self-reported poor health and adhering to the steps of WE can minimize RTMIP to ensure success of unsedated colonoscopy. |
BOOSTING EFFICIENCY IN THE ENDOSCOPY SUITE: INTEGRATING TEAM WORKFLOWS IMPROVES PRODUCTIVITY AND MINIMIZES COST. This study defines variations in TOT and demonstrates that finding imbalances and sharing the workload significantly cuts costs and improves the overall efficiency of the different subgroups in the turnover process. |
Distal Cap-assisted Endoscopic Mucosal Resection allows the safe and effective resection of adherent, dysplastic lesions in the setting of inflammatory bowel disease: a multicenter, retrospective study with video. EMR-DC represents an attractive option for the resection of adherent dysplastic lesions in chronic IBD which is effective, safe, and inexpensive. |
Preparation Regimens to Improve Capsule Endoscopy visualization and diagnostic yield (PrepRICE); a multicentric randomized trial. The group that received the bowel preparation the night before SBCE had poorer outcomes. Intra-procedure purgative regimens reduced SBTT, enhanced visualization, improved DY, and increased angioectasia detection. G4 was the best-tolerated regimen. |
THE ROLE OF MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY FOR PREVENTING PANCREATIC FLUID COLLECTION RECURRENCE AFTER EUS-GUIDED DRAINAGE OF WALLED-OFF NECROSIS. Patients with WON who underwent MRCP prior to transmural stent removal had a lower rate of PFC recurrence largely due to the identification of DPD with appropriate endoscopic management. |
| Gut |
Faecal proteomics links neutrophil degranulation with mortality in patients with alcohol-associated hepatitis. We found an increased abundance of faecal proteins linked to neutrophil degranulation in patients with AH, which is predictive of short-term survival and could serve as a prognostic non-invasive marker. |
HBcrAg values may predict virological and immunological responses to pegIFN-α in NUC-suppressed HBeAg-negative chronic hepatitis B. PegIFN-α treatment can induce greater functional T cell improvement and HBsAg decline in patients with lower baseline HBcrAg levels. Thus, HBcrAg may represent an easily and reliably applicable parameter to select patients who are more likely to achieve better response to pegIFN-α add-on to virally suppressed patients. |
Impact of prenatal and postnatal maternal IBD status on offspring's risk of IBD: a population-based cohort study. Offspring had a greater risk of IBD when either parent was diagnosed before childbirth rather than later, emphasising genetic predisposition and environmental risk factors rather than maternal inflammation in utero as risk factors for IBD. |
| Hepatology |
Acute kidney injury in severe alcohol-associated hepatitis treated with anakinra plus zinc or prednisone. AKI occurred more frequently and was more severe in A+Z-treated participants. A+Z-treated participants with AKI had higher uNGAL, suggesting that A+Z maybe nephrotoxic in sAH patients. |
Ag-driven CD8+ T cell clonal expansion is a prominent feature of MASH in humans and mice. MASH-induced human cirrhosis and diet-induced MASH in mice resulted in the accumulation of activated and clonally expanded T cells in the liver. The clonally expanded T cells in the liver expressed markers of chronic antigenic stimulation, including PD1, TIGIT, and TOX. Overall, this study establishes for the first time that T cells undergo Ag-dependent clonal expansion and functional differentiation during the progression of MASH. These studies could lead to the identification of antigenic targets that drive T cell activation, clonal expansion, and recruitment to the liver during MASH. |
CX3CR1+ macrophages interact with hepatic stellate cells to promote hepatocellular carcinoma through CD8+ T cell suppression. We showed that CX3CR1+Ly6C+ macrophages migrate and interact with aHSCs in the peritumoral region where retinoids induce arginase-1 expression in CX3CR1+Ly6C+ macrophages, subsequently depriving CD8+ T cells of arginine and promoting HCC. |
Development and validation of pFIB scores for exclusion of significant liver fibrosis in pediatric MASLD. Analyzing several cohorts totaling approximately 1100 children and adolescents, we developed novel risk scores incorporating readily available clinical variables. In accordance with the aim of excluding pediatric MASLD-associated fibrosis, the scores performed better in non-selected cohorts of children and adolescents living with obesity than in patients referred to tertiary liver units. |
Drug interaction with Udp-Glucuronosyltransferase (UGT) enzymes is a predictor of drug-induced liver injury. Notably, drug interactions with UGT enzymes may independently predict DILI, and their combined use with the rule-of-two model further improves overall predictive performance. These findings could expand the currently available tools for assessing the potential for DILI in humans. |
Endothelial RUNX3 controls LSEC dysfunction and angiocrine LRG1 signaling to prevent liver fibrosis. RUNX3 deficiency in the endothelium induces LSEC dysfunction, LRG1 secretion, and liver fibrosis progression. Therefore, endothelial RUNX3 is a crucial gatekeeping factor in LSECs, and profibrotic angiocrine LRG1 may be a novel target for combating liver fibrosis. |
Epigenetic heterogeneity hotspots in human liver disease progression. Substantial epigenetic heterogeneity arises early in liver disease development, targeting key pathways in the progression and initiation of both cirrhosis and HCC. Integration of epigenetic and transcriptional heterogeneity unveils putative epigenetic regulators of hepatocarcinogenesis. |
Exome-wide association analysis identifies novel risk loci for alcohol-associated hepatitis. Polygenic signals for AH were observed in both common and rare variant analysis and identified genes with roles associated with inflammation. This study has identified two new genes of high effect size with a previously unknown contribution to ALD, and highlights both the overlap in etiology between liver diseases, and the unique origins of AH. |
Hepatic decompensation is the major driver of mortality in hepatocellular carcinoma patients treated with atezolizumab plus bevacizumab: The impact of successful antiviral treatment. Hepatic decompensation identifies patients with the worst prognosis following AB and is more common in patients with baseline ALBI>1 and non-viral aetiology. Effective antiviral treatment may protect from decompensation, highlighting the prognostic disadvantage of patients with non-viral aetiologies and the importance of multi-disciplinary management to maximise OS. |
Liver stiffness progression in biopsy-proven metabolic dysfunction-associated steatotic disease among people with diabetes versus people without diabetes: A prospective multicenter study. Utilizing serial VCTE data from a multicenter study of participants with biopsy-proven MASLD, we demonstrate that T2DM and HbA1c are associated with LSM progression. |
Liver transplantation provides survival benefit at all levels of frailty: From the Multicenter Functional Assessment in Liver Transplantation Study. Pre-LT and, to a lesser degree, post-LT mortality increased as LFI increased. Transplant offered a survival benefit at al LFI values, driven by a reduction in pre-LT mortality. No threshold of LFI was identified at which the risk of post-LT mortality exceeded pre-LT mortality. LT offers net survival benefit even in the presence of advanced frailty among those selected for LT. |
PGD2/DP1 axis promotes liver regeneration by secreting Wnt2 in Kupffer cells in mice. DP1 activation mediates crosstalk between KCs and hepatocytes through Wnt2, and facilitates liver regeneration. Hence, DP1 may serve as a novel therapeutic target in acute and chronic liver diseases. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
Review article: advances in the diagnosis and management of anorectal motility disorders. Anorectal motility disorders are common, but either less well recognized or poorly managed by most gastroenterologists. Equipped with the practical and up-to-date knowledge provided in this review, physicians could provide improved health care for these patients. |
| Clin Gastroenterol Hepatol |
Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to noncirrhotic Advanced Fibrosis. The approval of resmetirom also presents important challenges, including how to noninvasively identify patients with fibrosis stages 2-3, and how to exclude patients with more advanced disease who should not be treated until further data emerge on the use of resmetirom in this population. Herein we consider the available literature with regard to identifying the intended population for treatment with resmetirom and in proposing criteria for stopping treatment. |
THE FUTURE OF CLINICAL TRIALS IN INFLAMMATORY BOWEL DISEASE. Accordingly, innovative methods for both early and late phase RCTs must be adopted. In this Review, we provide a comprehensive overview of the evolution of modern IBD trials, discuss methods for improving trial efficiency both in early and late phase development, and provide insights into the interpretation and implications of these data for clinical care. |
The IBD Clinic of Tomorrow: Holistic, Patient-Centric, and Value-based Care. We also suggest potential opportunities for IBD practitioners to incorporate elements of holistic care on a local scale. Together, we hope such care models will enhance not only IBD-specific health outcomes, but also improve the general wellbeing of our patients with IBD today and tomorrow. |
| Gastrointest Endosc |
| Gut |
Cellular immunotherapies and immune cell depleting therapies in inflammatory bowel diseases: the next magic bullet? This article discusses novel cellular immunotherapies and immune cell depleting therapies in IBD, including CAR-T cell approaches, Tr1 and T regulatory (Treg) cells and cell depleting antibodies such as rosnilimab. These novel approaches have the potential to overcome current therapeutic limitations in the treatment of IBD. |
| J Hepatol |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Clin Gastroenterol Hepatol |
| Endosc Int Open |
| Endoscopy |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
|---|
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| J Hepatol |